Provider Demographics
NPI:1831119486
Name:BARBARA, JOSEPH C (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:C
Last Name:BARBARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7880 WREN AVE STE C133
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-7801
Mailing Address - Country:US
Mailing Address - Phone:408-842-0278
Mailing Address - Fax:408-842-8907
Practice Address - Street 1:7880 WREN AVE STE C133
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-7801
Practice Address - Country:US
Practice Address - Phone:408-842-0278
Practice Address - Fax:408-842-8907
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG28075207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G280750Medicaid
CA00G280750Medicare ID - Type Unspecified
CAZZZ04587ZMedicare PIN
CA00G280750Medicaid